Advances in Surgical Sciences

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Impact of Loco-regional Surgical Control on Survival of Extremity Soft Tissue Sarcoma among Patients of Hadhramout National Cancer Center

Received: Dec. 23, 2018    Accepted: Jan. 23, 2019    Published: Feb. 15, 2019
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Abstract

Background: Loco-regional surgery remains the mainstay therapy of extremity soft tissue sarcoma (ESTS) and provides the only chance of cure. Improvements of surgical technique, increased surgical experience, radiotherapy, adjuvant and neoadjuvant chemotherapy increased the survival. Aim of study: to evaluate the effect of the type of surgical intervention on the survival and quality of life of ESTS Patients. Methods: This is a prospective study to evaluate the impact of loco-regional surgical control on the survival among ESTS patients attended the National Cancer Center, Hadhramout -Yemen, between April 2010 and October 2018. Extremity soft tissue sarcoma patients were operated either by wide-local excision with safety margin or amputation or disarticulation. The study population consisted of 52 patients in which males and females represented (53.85%) and (46.15%) respectively. The three variable methods were compared using Chi-square test. Survival rate was analyzed by Kaplan-Meier test. Results: Fifty two patients, 12 patients in Group I (23, 1%), 10 patients in Group II (19.2%) and 30 patient’s in Group III (57.7%). The mean survival in patients underwent disarticulation was (77.5) months, while patients who had an amputation, the survival was (45.5) months, and in wide local resection patients was (59.9) months. The mean overall survival was (65.9) months, P value > (0.026) which was significant. Among the 3 different types of management, high overall survival rate was found in patients underwent disarticulation, while overall survival rate was also high in patient underwent wide local excision or compartmental resection in spite of functional limb preservation and good quality of life. The mean overall survival rate was low in patients who had limb amputation with loss of limb function. Conclusion: The wide local excision or compartmental resection mandates margin-negative, accepted post-operative local wound complication, associated with prolonged disease-free-survival and overall survival than other methods. Must be deal with improve patient overall survival, decrease local recurrence and obtained best Oncological outcome by preserve function with good quality of life for ESTS patients who underwent wide or compartmental resection or radical limb sparing surgery.

DOI 10.11648/j.ass.20190701.14
Published in Advances in Surgical Sciences ( Volume 7, Issue 1, June 2019 )
Page(s) 15-20
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Extremity Soft Tissue Sarcoma, Overall Survival, Local Control, Outcome

References
[1] Ferrone ML, Raut CP. Modern Surgical Therapy: Limb Salvage and the Role of Amputation for Extremity Soft-Tissue Sarcomas. Surg Oncol Clin N Am. 2012; 21 (2): 201-213. doi:10.1016/j.soc.2011.11.001.
[2] Brennan M, Alektiar KM, Maki RG. Soft tissue sarcoma. In: DeVita VT, Hellmann S, Rosenberg SA, editors. Cancer: principles and practice of oncology, 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2001: 1844–1891.
[3] Wardrop J. Observations on fungus haematodes or soft cancer. Edinburgh: G Ramsay; 1809.
[4] Erstad D, Ready J, Abraham J, et. Al. Amputation for Extremity Sarcoma: Contemporary Indications and Outcomes. Annals of Surgical Oncology. 2018 vol: 25 (2) pp: 394-403. Doi; 10.1245/s10434-017-6240-5.
[5] Fletcher C, Bridge JA Hogendoorn P, Mertens F (eds) (2013) WHO Classification of tumours of soft tissue and bone, 4th edn. IARC Press, Lyon.
[6] Smith HG, Thomas JM, Smith MJF, Hayes AJ, Strauss DC. Major Amputations for Extremity Soft-Tissue Sarcoma. Ann SurgOncol. 2018; 25 (2): 387-393. doi:10.1245/s10434-017-5895-2.
[7] Shiu MH, Castro EB, Hajdu SI, Fortner JG. Surgical treatment of 297 soft tissue sarcomas of the lower extremity. Ann Surg. 1975; 182 (5): 597-602. doi:10.1097/00000658-197511000-00011.
[8] Parsons CM, Pimiento JM, Cheong D, et al. The role of radical amputations for extremity tumors: A single institution experience and review of the literature. J SurgOncol. 2012; 105 (2): 149-155. doi:10.1002/jso.22067.
[9] Yang JC, Chang AE, Baker AR, et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol. 1998; 16 (1):197-203. doi:10.1200/JCO.1998.16.1.197.
[10] Dancsok AR, Asleh-Aburaya K, Nielsen TO. Advances in sarcoma diagnostics and treatment. Oncotarget. 2017; 8 (4). doi:10.18632/oncotarget.12548.
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[12] Khan MM, 1, Waqar SH, et al. Surgical Management of Soft Tissue Sarcoma. J Rawalpindi Med Coll (JRMC. 2018; 22 (1): 58-62.
[13] Bonvalot S, Rimareix F, Paumier A, Roberti E, Bouzaiene H, Le Péchoux C. Actualisation de la stratégie thérapeutique locorégionale dans les sarcomes des tissusmous et les tumeursdesmoïdes des membres. Cancer/Radiothérapie. 2010; 14 (6-7): 455-459. doi:10.1016/j.canrad.2010.06.016.
[14] Parikh RC, Lorenzo M, Hess LM, Candrilli SD, Nicol S, Kaye JA. Treatment patterns and survival among older adults in the United States with advanced soft-tissue sarcomas. Clin Sarcoma Res. 2018; 8 (1): 8. doi:10.1186/s13569-018-0094-x.
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    Salah Ahmed Binziad, Abdulla Saleh Alyamani, Khalid Ahmed Baeesa, Waleed Khaled Kaleem, Adnan Abdullah Bakarman, et al. (2019). Impact of Loco-regional Surgical Control on Survival of Extremity Soft Tissue Sarcoma among Patients of Hadhramout National Cancer Center. Advances in Surgical Sciences, 7(1), 15-20. https://doi.org/10.11648/j.ass.20190701.14

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    Salah Ahmed Binziad; Abdulla Saleh Alyamani; Khalid Ahmed Baeesa; Waleed Khaled Kaleem; Adnan Abdullah Bakarman, et al. Impact of Loco-regional Surgical Control on Survival of Extremity Soft Tissue Sarcoma among Patients of Hadhramout National Cancer Center. Adv. Surg. Sci. 2019, 7(1), 15-20. doi: 10.11648/j.ass.20190701.14

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    AMA Style

    Salah Ahmed Binziad, Abdulla Saleh Alyamani, Khalid Ahmed Baeesa, Waleed Khaled Kaleem, Adnan Abdullah Bakarman, et al. Impact of Loco-regional Surgical Control on Survival of Extremity Soft Tissue Sarcoma among Patients of Hadhramout National Cancer Center. Adv Surg Sci. 2019;7(1):15-20. doi: 10.11648/j.ass.20190701.14

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  • @article{10.11648/j.ass.20190701.14,
      author = {Salah Ahmed Binziad and Abdulla Saleh Alyamani and Khalid Ahmed Baeesa and Waleed Khaled Kaleem and Adnan Abdullah Bakarman and Moutez Alyazedi},
      title = {Impact of Loco-regional Surgical Control on Survival of Extremity Soft Tissue Sarcoma among Patients of Hadhramout National Cancer Center},
      journal = {Advances in Surgical Sciences},
      volume = {7},
      number = {1},
      pages = {15-20},
      doi = {10.11648/j.ass.20190701.14},
      url = {https://doi.org/10.11648/j.ass.20190701.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ass.20190701.14},
      abstract = {Background: Loco-regional surgery remains the mainstay therapy of extremity soft tissue sarcoma (ESTS) and provides the only chance of cure. Improvements of surgical technique, increased surgical experience, radiotherapy, adjuvant and neoadjuvant chemotherapy increased the survival. Aim of study: to evaluate the effect of the type of surgical intervention on the survival and quality of life of ESTS Patients. Methods: This is a prospective study to evaluate the impact of loco-regional surgical control on the survival among ESTS patients attended the National Cancer Center, Hadhramout -Yemen, between April 2010 and October 2018. Extremity soft tissue sarcoma patients were operated either by wide-local excision with safety margin or amputation or disarticulation. The study population consisted of 52 patients in which males and females represented (53.85%) and (46.15%) respectively. The three variable methods were compared using Chi-square test. Survival rate was analyzed by Kaplan-Meier test. Results: Fifty two patients, 12 patients in Group I (23, 1%), 10 patients in Group II (19.2%) and 30 patient’s in Group III (57.7%). The mean survival in patients underwent disarticulation was (77.5) months, while patients who had an amputation, the survival was (45.5) months, and in wide local resection patients was (59.9) months. The mean overall survival was (65.9) months, P value > (0.026) which was significant. Among the 3 different types of management, high overall survival rate was found in patients underwent disarticulation, while overall survival rate was also high in patient underwent wide local excision or compartmental resection in spite of functional limb preservation and good quality of life. The mean overall survival rate was low in patients who had limb amputation with loss of limb function. Conclusion: The wide local excision or compartmental resection mandates margin-negative, accepted post-operative local wound complication, associated with prolonged disease-free-survival and overall survival than other methods. Must be deal with improve patient overall survival, decrease local recurrence and obtained best Oncological outcome by preserve function with good quality of life for ESTS patients who underwent wide or compartmental resection or radical limb sparing surgery.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Impact of Loco-regional Surgical Control on Survival of Extremity Soft Tissue Sarcoma among Patients of Hadhramout National Cancer Center
    AU  - Salah Ahmed Binziad
    AU  - Abdulla Saleh Alyamani
    AU  - Khalid Ahmed Baeesa
    AU  - Waleed Khaled Kaleem
    AU  - Adnan Abdullah Bakarman
    AU  - Moutez Alyazedi
    Y1  - 2019/02/15
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ass.20190701.14
    DO  - 10.11648/j.ass.20190701.14
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
    SP  - 15
    EP  - 20
    PB  - Science Publishing Group
    SN  - 2376-6182
    UR  - https://doi.org/10.11648/j.ass.20190701.14
    AB  - Background: Loco-regional surgery remains the mainstay therapy of extremity soft tissue sarcoma (ESTS) and provides the only chance of cure. Improvements of surgical technique, increased surgical experience, radiotherapy, adjuvant and neoadjuvant chemotherapy increased the survival. Aim of study: to evaluate the effect of the type of surgical intervention on the survival and quality of life of ESTS Patients. Methods: This is a prospective study to evaluate the impact of loco-regional surgical control on the survival among ESTS patients attended the National Cancer Center, Hadhramout -Yemen, between April 2010 and October 2018. Extremity soft tissue sarcoma patients were operated either by wide-local excision with safety margin or amputation or disarticulation. The study population consisted of 52 patients in which males and females represented (53.85%) and (46.15%) respectively. The three variable methods were compared using Chi-square test. Survival rate was analyzed by Kaplan-Meier test. Results: Fifty two patients, 12 patients in Group I (23, 1%), 10 patients in Group II (19.2%) and 30 patient’s in Group III (57.7%). The mean survival in patients underwent disarticulation was (77.5) months, while patients who had an amputation, the survival was (45.5) months, and in wide local resection patients was (59.9) months. The mean overall survival was (65.9) months, P value > (0.026) which was significant. Among the 3 different types of management, high overall survival rate was found in patients underwent disarticulation, while overall survival rate was also high in patient underwent wide local excision or compartmental resection in spite of functional limb preservation and good quality of life. The mean overall survival rate was low in patients who had limb amputation with loss of limb function. Conclusion: The wide local excision or compartmental resection mandates margin-negative, accepted post-operative local wound complication, associated with prolonged disease-free-survival and overall survival than other methods. Must be deal with improve patient overall survival, decrease local recurrence and obtained best Oncological outcome by preserve function with good quality of life for ESTS patients who underwent wide or compartmental resection or radical limb sparing surgery.
    VL  - 7
    IS  - 1
    ER  - 

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Author Information
  • Department of Surgery, College of Medicine, Hadhramout University, Mukalla, Hadhramout, Yemen

  • Department of Surgery, College of Medicine, Hadhramout University, Mukalla, Hadhramout, Yemen

  • Department of Orthopedic Surgery, College of Medicine, Hadhramout University, Mukalla, Hadhramout, Yemen

  • Department of Clinical Oncology, Faculty of Medicine, Hadhramout University, Mukalla, Hadhramout, Yemen

  • Department of Hematology, Faculty of Medicine Hadhramout University, Mukalla, Hadhramout, Yemen

  • Family Medicine, Faculty of Medicine, Hadhramout University, Mukalla, Hadhramout, Yemen

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